Avodart (Dutasteride) – Short-Term Course for People with BPH before TURP

Dutasteride (Avodart) is a prescribed medicine classified under the group of drugs known as 5-alpha reductase inhibitors. Its main use is in the treatment of benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate. Dutasteride works by preventing the transformation of testosterone into dihydrotestosterone (DHT), which aids in reducing prostate size, easing urinary issues, and enhancing overall urine flow.

Management of BPH

BPH treatment has the following objectives:

• Reduce the BPH symptoms;
• Prevent the BPH progression to reduce risk of acute urinary retention and the need surgery.

Medical treatment of benign prostatic hypertrophy can use three types of medications: plant extracts, alphablockers which have an essentially symptomatic effect, and inhibitors of 5-α-reductase (“5-ARI”) which, through their hormonal action, reduces the volume of the prostate gland, and therefore, can improve clinical symptomatology and reduce the risk of long-term complications. Dutasteride, a new 5-α-reductase inhibitor, has shown a specific action in medical research by decreasing the volume of the transition zone in contact with the prostatic urethra. Nevertheless, in the event of failure or contraindication of medical treatment (because of the importance of the symptoms), the removal of obstructive prostatic tissue, most often by TransUretral Prostate Resection (TURP), remains the surgical treatment. The most widely practiced because it allows rapid and lasting improvement of urinary symptoms. Per and postoperative hemorrhage is the most commonly reported complication. The mechanisms usually evoked to explain the effect of “5-ARI” on hematuria related to BPH and on TURP hemorrhage are related to the reduction of microvasculature density of prostatic epithelium and regulating the activity of growth factors of androgen-controlled angiogenesis.

Indications for taking Dutasteride before TURP

Be careful with Dutasteride:

• In some clinical studies, patients taking dutasteride with another drug called alpha-blocker (such as tamsulosin) were more likely to have heart failure than patients taking only dutasteride or an alpha-blocker. Heart failure means that your heart does not pump blood as well as it should.
• Make sure your doctor is aware of your liver problems. If you have had diseases that have affected your liver, you may need to undergo additional tests during treatment with Dutasteride.
• Women, children and adolescents should not handle damaged Dutasteride medical capsules as the active substance can be absorbed through the skin. If skin contact occurs, wash area immediately with soap and water.
• Use a condom during sex. Dutasteride was found in the sperm of some men. If your partner is pregnant or is likely to become pregnant, you should avoid exposure to your sperm as dutasteride can affect the normal development of a male fetus. Dutasteride has been shown to decrease sperm count, ejaculate volume and sperm motility. Male fertility can be reduced.
• Dutasteride has an impact on the blood test of PSA (prostate specific antigen), which is sometimes used to detect prostate cancer. Your doctor should be aware of this effect, but may use the test to detect prostate cancer. If you are performing a PSA blood test, tell your doctor that you are taking Dutasteride. Men taking Dutasteride must have their PSA tested regularly.
• In a clinical study in men at increased risk of prostate cancer, men who took Dutasteride had a more severe form of prostate cancer more often than men who had not taken Dutasteride. The effect of Dutasteride on this severe form of prostate cancer is unclear.
• Dutasteride can cause enlargement and breast pressure. If this becomes troublesome, or if you notice breast enlargement or nipple discharge, you should discuss these changes with your doctor as they may be signs of more serious conditions, such as breast cancer.

What are the possible side effects of Dutasteride?

Like all medicines, Avodart can cause side effects, although not everybody gets them.

Allergic reactions:

Signs of allergic reactions may include:

• Rash (itching possible)
• Urticaria (such as an eruption due to nettles)
• Swelling of the eyelids, face, lips, arms or legs.

Contact your doctor immediately if you have any of these symptoms and stop taking Avodart.

Common side effects:

They are likely to affect up to 1 in 10 men treated with AVODART:

• Inability to get or maintain an erection (impotence), which may continue after you stop taking Avodart
• Decreased libido, which may continue after you stop taking Avodart
• Ejaculation disorders, which may continue after you stop taking Avodart
• Swelling or tenderness of the breasts (gynecomastia)
• Dizziness when used with tamsulosin.

Uncommon side effects:

They are likely to affect up to 1 in every 100 people treated with Avodart:

• Heart failure (the heart becomes less effective at ejecting blood into the body, you may experience symptoms such as: shortness of breath, extreme tiredness and swelling of the ankles and legs),
• Hair loss and / or excessive hair growth.

The frequency cannot be estimated from the available data:

• Depressed mood
• Pain and swelling of your testicles